TMJ & TMD Frequently Asked Questions

What is TMJ / TMD?

TMJ (temporal mandibular joint) is a term that has been used for many years to describe many painful conditions of the jaw joint and accompanying muscles. More recently the term TMD (temporal mandibular disorder) is being used to describe a broader group of symptoms of the head and neck.

The most obvious sign is clicking or popping in the joint that may or may not cause pain, and could include many other symptoms such as headaches and neck pain. Patients suffering with TMJ can frequently have other seemingly un-related symptoms such as dizziness, ringing in the ears, and neck and shoulder pain. These signs and symptoms many times can be misdiagnosed or not understood to relate to the bite and joint. It is estimated that as many as 40 million people suffer from TMJ/TMD many of whom do not realize that effective treatment is available.

Could I have TMJ/TMD?

There can be many causes for TMJ/TMD but by far the most common cause is a bad bite. However, infrequently trauma such as whiplash or tooth extractions or even orthodontic treatment can initiate symptoms. The most common symptom of TMJ/TMD is clicking or popping of the jaw joint. But there are many other symptoms that can be cause by TMJ/TMD these may include any of the following symptoms:

clicking or popping

joint pain

headaches/migraines

neck and shoulder pain

dizziness

ringing in the ears

facial pain

pain in the temples or forehead

Patients suffering from TMJ/TMD can exhibit many or some of these symptoms. Some patients suffering from TMJ/TMD can experience many of the above symptoms without clicking or popping of the jaw joint. These signs and symptoms frequently can be misdiagnosed or not understood to relate to the bite and the joint. Indeed even many dental professionals not trained in Neuromuscular dentistry may not relate some of these signs and symptoms to your bite.

How do dentists treat TMJ/TMD?

Conventional treatment typically involved “splint therapy” to treat the joint but ignored the underlying contribution of the muscles relating to TMD. This was the dentist’s best guess as to the patients correct jaw position. Some patient’s symptoms were improved but many were not helped. Through the use of state of the art technology the neuromuscular dentist can much more accurately determine how to correct a misaligned bite. After the correct bite has been determined an orthotic can be made to re-position the jaw to the correct bite. This treatment is diagnostic and completely reversible. While some changes to the bite can be minor the effect on relieving symptoms can be profound. Most patients suffering from TMJ/TMD can now be very effectively helped through modern neuromuscular techniques. Insurance, financing, or personal loans can easily cover the cost of our treatments.

What is Neuromuscular dentistry and what are the benefits?

Neuromuscular Dentistry is the science of using the relaxed position of the muscles of the head and neck to place the jaw into the correct anatomical position. This is accomplished through the use of an ultra low frequency TENS unit to relax the muscles. Once the muscles are relaxed as determined by computerized EMG analysis this position can be recorded to provide an exact determination of the correct bite. This bite is then used to fabricate an orthotic to place the jaw in an orthopedically correct position. The orthotic is a completely reversible diagnostic appliance that the patient and dentist can use to determine the effectiveness of treatment of the misaligned bite. For some, treatment may include permanent changes to the bite through dental rehabilitation or Neuromuscular orthodontics. (Neuromuscular dentistry is the foundation of modern headache treatment).

Chronic Headaches & Migraines

What causes headaches?

While there are many causes of headaches the most common cause is inflammation of the muscles in the head and neck. Symptoms of headaches can vary from merely annoying pain to debilitating, excruciating pain that makes normal daily activity impossible. The location and severity of the pain can vary depending which muscles are involved and how severely inflamed they are. These muscles can become inflamed through overuse from clenching and posturing. Most of the time patients are completely unaware of their clenching habits particularly the clenching and grinding that can occur during sleep. The most common cause of this clenching and grinding is a misaligned bite that does not allow the jaw to rest in a comfortable and relaxed position. While headaches can typically be treated with over the counter or prescription medications these drugs are all aimed at treating the symptoms mainly the inflammation rather than the root cause of the pain. Success with these medications varies with few patients ever really achieving complete relief.

Could my headaches be caused by my bite?

While teeth may look perfectly straight, they may not contact in a way that allows the muscles to remain relaxed. Indeed, many patients that have received conventional orthodontic treatment find that their teeth look perfectly straight and yet they suffer chronic headaches or migraines without ever associating their headaches with their bite. This is particularly true in cases where teeth have been extracted in order to cosmetically straighten the teeth without adequately addressing the underlying anatomical considerations. A comprehensive Neuromuscular evaluation with computerized EMG analysis can determine if your headaches are caused by your bite.

How can correcting a bad bite help my headaches?

By determining the correct relaxed position of your jaw an appliance called an orthotic can be precisely fabricated to correct the bite. These appliances are removable and are used to help diagnose and treat your headaches. Once your headaches are correctly diagnosed and treated a long term treatment can be determined. This may include simply continuing to wear the appliance at night, changes to previous dental work or possibly NM orthodontics. It is important to keep in mind the goal of having a “pain free, drug free” life.

How can chronic headaches be treated?

Most headaches, including migraines, may feel as though they are in your brain. In reality, the pain is actually coming from inflamed muscles of the head and neck. The location and severity of the pain can vary depending on which muscles are involved and how severe the inflammation is. The role of neuromuscular dentistry involves identifying and treating inflamed, hyperactive muscles and nerves.

What is referred pain?

Referred pain has been a well known phenomenon to both medicine and dentistry for many years. Many pathways of referred pain relate to headaches and generalized head and neck pain. These are of particular interest in neuromuscular dentistry since many areas of pain can actually be traced to other areas of neuromuscular origin. In order to achieve successful resolution of symptoms all sources of pain must be addressed. The list of videos below illustrate some of the most common trigger points and the pathways of referred pain. The red dot indicates the origin of the pain the yellow dots indicate the area the pain is perceived.